Osteoarthritis is a degenerative disease of cartilage tissue that can affect the joints of the vertebrae and all bones of the skeleton.The hip joint (HJ) is the largest and most loaded bony joint.Therefore, coxarthrosis (deforming arthrosis of the hip joint) is a very common cause of disability in patients over 50 years of age.
Coxarthrosis (arthrosis of the hip joint): symptoms
Reasons
The causes of coxarthrosis are different.This pathology can lead to:
- Age-related dystrophic changes in cartilage.
- Constant physical activity among athletes and carrying heavy loads for several years.
- Congenital dysplasia.
- TJ injuries.
- Necrosis of the femoral head (Perthes disease).
The head of the femur, covered with elastic cartilage, is located in the acetabulum of the pelvic bones.
There are unilateral lesions (when the disease affects one joint) and bilateral lesions - when both articular hip surfaces are affected.
Symptoms of arthrosis of the hip joint
At diagnosis, the following symptoms of arthrosis of the hip joint are observed:
- Thinning of the cartilage, it becomes dry and rough.
- Thickening of the underlying bone, its growth to the sides.
- Fibrosis and inflammation of the joint capsule.
- The appearance of an inflammatory exudate in the capsule.
- Stiffness of the joint, occurrence of contractures.
Externally, these changes are manifested by the following symptoms:
- Joint pain radiating to groin, hip and knee.
- The initial (morning) symptom of pain that disappears after warming up.
- A stiff, unsteady, limping gait.
- By shortening the leg on the affected side (the reason for this is a contracture).
- Weakening and atrophy of the thigh muscle.
- Creaking in the joint.
Stages of the disease
Based on the signs and symptoms, three stages of the disease can be distinguished:
First
- Discomfort and pain that usually subsides with rest.
- Absence of external symptoms - lameness, stiffness, atrophy.
Such signs do not particularly worry patients, and few people pay attention to episodic pain, even less begin to treat it.
But right at the initial stage, arthrosis of the hip joint is still a reversible disease.
Second degree
- Painful symptoms become more intense and may continue even at rest.
- The functional characteristics of the hip joint decrease:
- limitations on hip abduction and internal rotation occur
- lameness is observed
- X-rays show:
- marginal osteophytes;
- deformation of the head and change of its contour;
- reduction of joint space.
Third stage
- The pain becomes constant, and the most excruciating night pains begin.
- The patient is forced to rely on a cane.
- There is a sharp limitation of movements and atrophy of the gluteal, thigh and calf muscles.
- There is noticeable leg shortening and limping.
- Due to overgrown osteophytes, the joint practically disappears, fusion and complete loss of function of the hip joint occurs.
It happens that the first attack occurs at a fairly early age - in the early forties.A person most likely forgets about it and remembers it already at the age of 50-60, when the deformations in the joint become significant, which affects the quality of life.
Diagnosis
X-ray and functional diagnostics are performed.The orthopedist not only deciphers the image, but also rotates, bends the femur in all directions and studies the symptoms that occur when walking.
However, more and more often, if the patient suspects coxarthrosis of the hip joint, leading specialists refer for diagnosis using magnetic resonance imaging (MRI).The explanation for this is the absolute safety and high informativeness of the procedure.It is the MRI study that allows detecting the smallest changes in the hip joint at an early stage, which contributes to the development of the most effective treatment tactics.
Treatment of coxarthrosis of the hip joint
Treatment is carried out on the principle of "the sooner the better".
Early coxarthrosis can be treated with:
- Chondroprotectors.
- Light exercise - swimming, aerobics, walking and cycling.
- Regulation of permissible physical loads on the joint.
- Weight correction (down).
- Physiotherapy treatment
- Extraction procedures.
- Massage sessions.
- Compresses on the area of pain.
Painful symptoms can be relieved with NSAIDs.
Annual sanatorium treatment is also very effective.
Pain-relieving intra-articular corticosteroid injections can be used to treat more intense pain in the later stages.
Treatment of late-stage coxarthrosis is very difficult due to the complete effacement of the hip joint.Chondroprotectors in this case are absolutely useless.
All kinds of external means in the form of ointments and gels can relieve muscle spasms and pain, but, of course, they will not affect the condition of the diseased immobile joint in any way.That is why you should take a reasonable approach to all kinds of advertising that assures that by smearing the sore spot with ointment, you can soon forget about the disease.
Hip replacement
The only option for complete recovery of the hip joint in the third stage of coxarthrosis is surgery - endoprosthesis (arthroplasty) of the hip joint.
The endoprosthesis consists of two components: a head and a cup.
This operation is not easy:
- After the operation, a long period of rehabilitation is required.
- The healing of the joint is painful (pain can last for a year).
- You will need to walk for a while with the help of a walker or with the help of a cane for support.